Department of Gynecology, Félix Guyon Hospital, 97400 Saint-Denis, Ile de la Réunion, France.

Case report

A 26-year-old woman (G1P0), with non-contributive history, was referred to our facility at 21st week of her pregnancy. Her ultrasonographic examination found microcephaly with isolated occipital encephalocele. The pregnancy was terminated and the finding was confirmed.

Images 1, 2: 21 weeks of pregnancy; 2D images showing transverse (Image 1) and coronal (Image 2) scans of the fetal head with microcephaly (Image 1 - biometry of the fetal head corresponds just to 17 weeks of pregnancy) and occipital encephalocele (better visible on the Image 2). 

Images 3, 4: 21 weeks of pregnancy; 2D images showing transverse scans of the fetal head with encephalocele protruding out of the scull as slightly hyperechoic tissue. 

Images 5, 6: 21 weeks of pregnancy; the image 5 shows transverse scan of the fetal head with normal appearance of the cerebellum and inward scalloping of the frontal bones, also known as the "lemon sign." Image 6 shows normal appearance of the fetal spine.

Video 1: 21 weeks of pregnancy; the video shows transverse scan of the fetal head with encephalocele protruding out of the scull and floating within the amniotic fluid.

Images 7, 8: Postmortem images of the fetus with occipital encephalocele.